It’s no secret that missed appointments have a lasting impact on a healthcare center’s bottom line. In fact, a 2017 study revealed that, each year, no-shows cost the healthcare industry more than $150 billion. But when calculating the cost of a no-show, it’s important for FQHCs to consider losses that go beyond missed appointment hours. When you serve low-income populations, these losses can have a staggering impact on the health of patients, and ultimately on the health of the organization.
To truly practice patient-centered care, healthcare centers need to do more than just get patients in the door—they need to sufficiently help them maintain their health as well. And while missed appointments are a common and costly problem for every healthcare center, the issue is significantly magnified for those that treat low-income populations, who are more at risk for serious illnesses, including diabetes and high cholesterol. Given the multitude of barriers to adequate healthcare, low-income patients struggle to maintain their health on a daily basis. And because access to healthcare can be challenging due to time or travel constraints, they will often wait until a preventable or treatable health concern becomes a significant issue, landing them in the ER. Some of the most frequently missed appointments at FQHCs are those tied to preventive care—which can ultimately be instrumental in saving lives. There is strong evidence that getting patients in the door for cancer screenings or vaccinations can have a significant impact on health outcomes. Finding breast cancer early, for example, reduces a patient’s risk of dying from the disease by 25 to 30% or more.
Not only is “Improving the Patient Experience” #1 on the IHI’s Triple Aim -- happy patients are often seen as a clear marker of performance. So it’s no wonder that the patient experience accounts for a whopping 25% of a hospital’s value-based purchasing score under the CMS’ 2018 Hospital Value-Based Purchasing (VBP) Program guidelines -- complete with incentives or penalties for organizations that do or do not meet minimum requirements.
Missed appointments can have a dramatic and lasting impact on overall patient satisfaction. Every missed appointment could have been filled by another patient and will therefore increase the time that patients need to wait to see their doctor. Captain Kim Decker, chief of the Martin Army Community Hospital Healthcare Management Division at Fort Benning, Georgia, puts it well when she says “An appointment missed by you is an appointment missed by two.” When one patient misses an appointment, another has missed the chance for an appointment.
With appointment wait times growing by as much as 30% in the U.S., it’s no wonder that patients are feeling dissatisfied. And the longer a patient has to wait for an appointment, the greater the likelihood that they will either miss the appointment (making the problem cyclical) or choose another facility altogether.
In an effort to reverse the trend of declining health in underserved communities, many organizations are adopting a patient-centered approach to healthcare-- but what does that actually mean? True patient-centered care means that an individual’s health needs and desired outcomes drive all health care decisions and quality measurements. To do this effectively, providers will need to collaborate with patients and their families, which means better patient communication, more engagement and greater outreach. The challenge for FQHCs is that communication with underserved populations can be difficult to say the least. Language, literacy, and time limitations all play a role. However, there are a few best practices that, if utilized, can help combat missed appointments and put underserved patients at the center of their care:
1.) Leveraging mobile messaging for appointment reminders and outreach. In the United States, low-income and less educated individuals use text messaging 2-4 times more than those of a higher income or higher education level. Text messages have a 98% open rate, making them a more effective mode of communication than email or patient portals.
2.) Delivering messages in the patient’s native language, with vocabulary suited to patients whose reading level may not be above 5th grade.
3.) Using education programs to engage patients in their ongoing care, offering advice and suggestions in the form of simple, consumable tips. Patients with Hypertension, Type 2 Diabetes, High Cholesterol or Depression are a prime target for this type of campaign.
To learn more about effective ways to combat no-shows, use the form below to connect with the CareMessage team.